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Med/Surg

Test 1 - Cardiac

QuestionAnswer
Where is the SA node located and what is its normal rate? junction of the superior vena cava and the right atrium - 60 to 100
Where is the AV node located and what is its firing rate right atrial wall near the tricuspid valve - 40 to 60
What is the Cardiac Electrophysiology of the heart (the order) SA node --- AV node ---- Bundle of Hiss --- Right and Left Branches ----Purkinje fibers
What is the largest chamber of the heart? Left ventricle
A patient may undergo an ___________________ study in which electrodes are placed inside the heart in order to obtain an intracardiac ECG. electrophysiology (EP)
This is used to diagnose the dysrhythmia and to determine determine the most effective treatment plan. electrophysiology (EP) study
standard 12-lead ECG reflects the electrical activity primarily in the ___________ left ventricle - Note in patients with suspected right-sided heart damage, right-sided precordial leads are required to evaluate the right ventricle.
How is an EPS study done? temp pacemaker wires may be lightly sutured to the epicardium & brought through the chest wall. Wires may be used for temporary pacing & obtaining an atrial ECG - helpful in the differential diagnosis of tachydysrhythmias.
During diastole the mitral and tricuspid valves are ____. open
Where is the apical impulse or PMI (point of maximal impulse) located? 5th intercostal space
What is the relaxation phase of the heart refereed to as? Diastole
What is the contraction phase of the heart refereed to as? Systole
T or F - The right ventricle is two to three times more muscular than the left ventricle. the left ventricle. F - left is thicker because it must overcome high aortic and arterial pressures.
The ___________- valves are closed during diastole. semilunar
The coronary arteries are perfused during what? How would a faster heart rate effect perfusion? diastole - with a normal heart rate of 60 to 80 bpm there is a lot of time during diastole for perfusion. Increased heart rate shortens diastole and may lead decrease myocardial perfusion. This puts the patient at risk for myocardial ischemia.
_________ is the total amount of blood ejected by one of the ventricles in liters per minute. __________ is the amount of blood ejected from one of the ventricles per heart beat. Cardiac output, stroke volume
What are the three factors that determine stroke volume? preload, afterload, contractility
How do the hearts of men and women differ. Men generally have bigger hearts and women tend to have more narrow coronary arteries.
The three major effecs of estrogen are? 1) an increase in high-density lipoprotein (HDL) that transports cholesterol out of arteries (2) a reduction in low-density lipoprotein (LDL) that deposits cholesterol in the artery 3) dilatation of the blood vessels- enhance blood ow to the heart.
What are two major negative change of the heart that occur with aging? What are the effects? 1. loss of function of the cells throughout the conduction system leads to a slower heart rate. 2. Increase heart size -hypertrophy (thickening of the heart walls), which reduces the volume of blood that the chambers can hold.
What are four major barriers related to cardiac symptoms that lead to people not seeking prompt medical service. 1.lack of knowledge about the symptoms of heart disease 2. attributing symptoms to a benign source 3. denying symptom significance 4. feeling embarrassed about having symptoms
What are the most common S/S of CVD - Chest pain or discomfort - Shortness of breath or dyspnea - Peripheral edema, weight gain, abdominal distention due to enlarged spleen and liver or ascites (HF) - Palpitations - Unusual fatigue - Dizziness, syncope, or changes in LOC
_______________________________is an emergent situation characterized by an acute onset of myocardial ischemia that results in myocardial death (i.e., MI) if denitive interventions do not occur promptly. Acute coronary syndrome (ACS) aka unstable angina
To differentiate among the causes of chest pain, the nurse asks the patient what three things? 1.to identify the quantity (0 = no pain to 10 = worst pain) 2. location 3. quality of pain.
During an ______, patients may report chest pain from myocardial ischemia, shortness of breath from Heart Failure, and palpitations from dysrhythmias. Both HF and dysrhythmias can be complications of an acute MI. MI
What are some important points to keep in mind when assessing patents reporting chest pain? - The location of chest symptoms is not well correlated with the cause of the pain. - The severity or duration of chest pain or discomfort does not predict the seriousness of its cause. -More than 1 clinical cardiac condition may occur simultaneously
Some non modifiable risk factors related to cardiac issues include age. male sex and race. List 6 modifiable risk factors. 1. smoking 2. Hypertention (drugs can be taken to lower this) 3. High cholesterol 4. Diabetes 5. Obesity 6. Physical inactivity These can all be modified by lifestyle changes or medications.
Characteristics of what? Uncomfortable pressure, squeezing or fullness in substernal chest. Can radiate across chest to the medial aspect of 1 or both arms, jaw, shoulders, upper back, or epigastrium. Radiation to arms & hands - (numbness or aching.) Angina
What is the duration of Angina? What are the precipitating events and aggravating factors? 5 to 15 minutes - physical exertion, emotional upset, eating large meals or expose to extremes in temperature
Characteristics of what? Same S/S of Angina Pectoris. Pain or Discomfort ranges from mild to sever. Associated with shortness of breath, diaphoresis, palpitations, unusual fatigue, and N/V ACS aka Unstable angina
Alleviating factors for Angina (list 4) Rest, nitroglycerin, oxygen and pain management
Alleviating factors for ACS aka unstable angina (list 2) 1. morphine 2. reperfusion of coronary artery with thrombolytic (fibrinolytic) agents or percutaneous coronary intervention
What is the term for Suddenly awakening with shortness of breath ? What is this a symptom of? Paroxysmal Nocturnal dyspnea - This is a symptom of worsening heart failure.
What causes Paroxymal nocturnal dyspnea? Reabsorption of fluid from dependent areas of the body (arms & legs) back into the circulatory system within hours of lying in bed. Shift increases preload & places increased demand on the heart of patients with HF, causing sudden pulmonary congestion.
Patients with worsening HF often experience________, a term used to indicate the need to sit upright or stand to avoid feeling short of breath. What will patients experiencing report? breath. What will patients experiencing report? orthopnea - Patients experiencing orthopnea will report that they need to sleep upright in a chair or add extra pillows to their bed.
Created by: sbertelsen
 

 



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